Precontoured locking plate fixation for displaced lateral clavicle fractures

Displaced fractures of the lateral end of the clavicle are associated with an increased risk of nonunion with conservative treatment; therefore, operative treatment is recommended. Various operative treatments have been suggested, but no consensus exists regarding a gold standard for the surgical treatment of this type of fracture. The purpose of this study was to evaluate clinical and radiological outcomes using a precontoured locking compressive distal clavicular plate for Neer type II distal clavicle fractures. Thirty-five patients with Neer type II distal clavicle fractures underwent surgery between March 2009 and January 2012. All patients were evaluated for function using the Constant-Murley Shoulder Outcome Score and University of California, Los Angeles shoulder rating scale, active shoulder range of motion, time to bone union, and coracoclavicular distance. Mean follow-up was 24.2 months (range, 12-35 months). No significant difference existed between the injured and contralateral sides in mean Constant-Murley scores (P=.13) or mean University of California, Los Angeles shoulder rating (P=.27). All patients obtained bony union over a mean of 4.1 months (range, 3.5-6.0 months).The coracoclavicular distance was not significantly different between the injured and contralateral shoulders in the immediate postoperative period (P=.28) or at final follow-up (P=.35). One superficial wound infection occurred, but no major complications, such as nonunion, plate failure, secondary fracture, or deep infection, occurred. Precontoured locking compressive distal clavicular plate fixation for the treatment of displaced fractures of the lateral end of the clavicle is an acceptable surgical method with good results.